Vascular compactness of unruptured brain arteriovenous malformation predicts risk of hemorrhage after stereotactic radiosurgery.

Arteriovenous malformation morphology Automated segmentation Compactness index Post-SRS hemorrhage Stereotactic radiosurgery Vascular disorders

Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
18 Feb 2024
Historique:
received: 13 11 2023
accepted: 12 02 2024
medline: 19 2 2024
pubmed: 19 2 2024
entrez: 18 2 2024
Statut: epublish

Résumé

The aim of the study was to investigate whether morphology (i.e. compact/diffuse) of brain arteriovenous malformations (bAVMs) correlates with the incidence of hemorrhagic events in patients receiving Stereotactic Radiosurgery (SRS) for unruptured bAVMs. This retrospective study included 262 adult patients with unruptured bAVMs who underwent upfront SRS. Hemorrhagic events were defined as evidence of blood on CT or MRI. The morphology of bAVMs was evaluated using automated segmentation which calculated the proportion of vessel, brain tissue, and cerebrospinal fluid in bAVMs on T2-weighted MRI. Compactness index, defined as the ratio of vessel to brain tissue, categorized bAVMs into compact and diffuse types based on the optimal cutoff. Cox proportional hazard model was used to identify the independent factors for post-SRS hemorrhage. The median clinical follow-ups was 62.1 months. Post-SRS hemorrhage occurred in 13 (5.0%) patients and one of them had two bleeds, resulting in an annual bleeding rate of 0.8%. Multivariable analysis revealed bAVM morphology (compact versus diffuse), bAVM volume, and prescribed margin dose were significant predictors. The post-SRS hemorrhage rate increased with larger bAVM volume only among the diffuse nidi (1.7 versus 14.9 versus 30.6 hemorrhage per 1000 person-years in bAVM volume < 20 cm

Identifiants

DOI: 10.1038/s41598-024-54369-2 PMID: 38369533
pubmed: 38369533
doi: 10.1038/s41598-024-54369-2
pii: 10.1038/s41598-024-54369-2
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

4011

Subventions

Organisme : Ministry of Science and Technology, Taiwan
ID : 109-2314-B-075 -051 -MY2
Organisme : Ministry of Science and Technology, Taiwan
ID : 110-2314-B-075 -038 -MY2

Informations de copyright

© 2024. The Author(s).

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Auteurs

Po-Wei Huang (PW)

Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.

Syu-Jyun Peng (SJ)

Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

David Hung-Chi Pan (DH)

Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.

Huai-Che Yang (HC)

Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Jo-Ting Tsai (JT)

Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Cheng-Ying Shiau (CY)

Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

I-Chang Su (IC)

Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.

Ching-Jen Chen (CJ)

Department of Neurosurgery, University of Texas Health Science Center, Houston, TX, USA.

Hsiu-Mei Wu (HM)

Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Chung-Jung Lin (CJ)

Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Wen-Yuh Chung (WY)

Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.

Wan-Yuo Guo (WY)

Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Wei-Lun Lo (WL)

Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.

Shao-Wen Lai (SW)

Product and Engineering, Zippin, San Carlos, CA, USA.

Cheng-Chia Lee (CC)

Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. yfnaughty@gmail.com.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. yfnaughty@gmail.com.
Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. yfnaughty@gmail.com.

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